Erin M Spaulding1, Francoise A Marvel2, Matthias A Lee3, William E Yang4, Ryan Demo2, Jane Wang4, Helen Xun4, Lochan Shah4, Daniel Weng4, Oluwaseun E Fashanu2, Jocelyn Carter5, Julie Sheidy6, Renee McLin6, Jennifer Flowers6, Maulik Majmudar7, Eric Elgin6, Valerie Vilarino8, David Lumelsky8, Vinayak Bhardwaj9, William Padula9, Jerilyn K Allen1,4,9, Seth S Martin2,3,4. 1. Johns Hopkins University School of Nursing, Baltimore, MD (E.M.S., J.K.A.). 2. Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD (F.A.M., O.E.F., S.S.M.). 3. Whiting School of Engineering, Johns Hopkins University, Baltimore, MD (M.A.L., R.D., S.S.M.). 4. Johns Hopkins University School of Medicine, Baltimore, MD (W.E.Y., J.W., H.X., L.S., D.W., J.K.A., S.S.M.). 5. Massachusetts General Hospital, Boston (J.C.). 6. Reading Hospital, West Reading, PA (J.S., R.M., J.F., E.E.). 7. Harvard Medical School, Boston, MA (M.M.). 8. Johns Hopkins University Krieger School of Arts and Sciences, Baltimore, MD (V.V., D.L.). 9. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (V.B., W.P., J.K.A.).
Abstract
BACKGROUND: Unplanned readmissions after hospitalization for acute myocardial infarction are among the leading causes of preventable morbidity, mortality, and healthcare costs. Digital health interventions could be an effective tool in promoting self-management, adherence to guideline-directed therapy, and cardiovascular risk reduction. A digital health intervention developed at Johns Hopkins-the Corrie Health Digital Platform (Corrie)-includes the first cardiology Apple CareKit smartphone application, which is paired with an Apple Watch and iHealth Bluetooth-enabled blood pressure cuff. Corrie targets: (1) self-management of cardiac medications, (2) self-tracking of vital signs, (3) education about cardiovascular disease through articles and animated videos, and (4) care coordination that includes outpatient follow-up appointments. METHODS AND RESULTS: The 3 phases of the MiCORE study (Myocardial infarction, Combined-device, Recovery Enhancement) include (1) the development of Corrie, (2) a pilot study to assess the usability and feasibility of Corrie, and (3) a prospective research study to primarily compare time to first readmission within 30 days postdischarge among patients with Corrie to patients in the historical standard of care comparison group. In Phase 2, the feasibility of deploying Corrie in an acute care setting was established among a sample of 60 patients with acute myocardial infarction. Phase 3 is ongoing and patients from 4 hospitals are being enrolled as early as possible during their hospital stay if they are 18 years or older, admitted with acute myocardial infarction (ST-segment-elevation myocardial infarction or type I non-ST-segment-elevation myocardial infarction), and own a smartphone. Patients are either being enrolled with their own personal devices or they are provided an iPhone and/or Apple Watch for the duration of the study. Phase 3 started in October 2017 and we aim to recruit 140 participants. CONCLUSIONS: This article will provide an in-depth understanding of the feasibility associated with implementing a digital health intervention in an acute care setting and the potential of Corrie as a self-management tool for acute myocardial infarction recovery.
BACKGROUND: Unplanned readmissions after hospitalization for acute myocardial infarction are among the leading causes of preventable morbidity, mortality, and healthcare costs. Digital health interventions could be an effective tool in promoting self-management, adherence to guideline-directed therapy, and cardiovascular risk reduction. A digital health intervention developed at Johns Hopkins-the Corrie Health Digital Platform (Corrie)-includes the first cardiology Apple CareKit smartphone application, which is paired with an Apple Watch and iHealth Bluetooth-enabled blood pressure cuff. Corrie targets: (1) self-management of cardiac medications, (2) self-tracking of vital signs, (3) education about cardiovascular disease through articles and animated videos, and (4) care coordination that includes outpatient follow-up appointments. METHODS AND RESULTS: The 3 phases of the MiCORE study (Myocardial infarction, Combined-device, Recovery Enhancement) include (1) the development of Corrie, (2) a pilot study to assess the usability and feasibility of Corrie, and (3) a prospective research study to primarily compare time to first readmission within 30 days postdischarge among patients with Corrie to patients in the historical standard of care comparison group. In Phase 2, the feasibility of deploying Corrie in an acute care setting was established among a sample of 60 patients with acute myocardial infarction. Phase 3 is ongoing and patients from 4 hospitals are being enrolled as early as possible during their hospital stay if they are 18 years or older, admitted with acute myocardial infarction (ST-segment-elevation myocardial infarction or type I non-ST-segment-elevation myocardial infarction), and own a smartphone. Patients are either being enrolled with their own personal devices or they are provided an iPhone and/or Apple Watch for the duration of the study. Phase 3 started in October 2017 and we aim to recruit 140 participants. CONCLUSIONS: This article will provide an in-depth understanding of the feasibility associated with implementing a digital health intervention in an acute care setting and the potential of Corrie as a self-management tool for acute myocardial infarction recovery.
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